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WAMC PHARMACY RESIDENCY PGY1 PROGRAM Residency Handbook

Womack Army Medical Center PGY1 Residency Military Handbook –Reviewed 4 January 2017 1

PGY1 PHARMACY RESIDENCY PROGRAM

Military Residents

Manual

WOMACK ARMY MEDICAL CENTER

FORT BRAGG, NC



SECTION I. INTRODUCTION

TABLE OF CONTENTS

Institutional Overview …………………………………………………………………………… 4

Department of Pharmacy Mission and Vision

PGY1 Residency Program Purpose Statement ……………………………………… .......... 5

Residency Training Outcomes

Departmental Organization Chart………………………………………………………… .......... 6

SECTION II. REQUIREMENTS

Resident Selection/Contract/Training agreement …………………………………... 6

Liability Insurance

Minimum Completion Requirements

Resident Notebook ………………………………………………………………………………... 7

PharmAcademic

Benefits

Out-Processing

SECTION III. DEPARTMENT AND PROGRAM STRUCTURE Department

Chair ………………………………………………………………………………. .................................... 8

Residency Program Director

Residency Coordinator/Administrator

Preceptors ………………………………………………………………………………………… ............ 8

Residency Academic Advisor/Mentor…………………………………………………. ............ 9

Residency Project Advisors………………………………………………………………… ............ 10

Committees

Organizational structures …………………………………………………………………… .......... 11

SECTION IV. RESIDENT RESPONSIBILITIES AND SUPERVISION

DMHRSi …………………………………………………………………………………………….............. 11

Academic and Professional Performance Standards

Army Physical Fitness………………………………………………………………………. ............... 12

Military Evaluation Reports

Supervision

Duty Hours

Institutional Moonlight Policy…………………………………………………………… .............. 13

Reporting

Wear and Appearance of ARMY Uniform and Insignia

Institutional Training

Department and Program Specific training ………………………………………… ............ 14

Basic Life Support (BLS)/Advanced Cardiovascular Life Support (ACLS)

Competency Assessment File



Presentations

Standards of Conduct for Department of ARMY personnel ……………………… 14

Code of Ethics for Pharmacists……………………………………………………………….. 16

Disclosure of Information

WAMC Policy and Procedure for Vendor Interaction …………………………….... 16

Conferences………………………………………………………………………………………….. 17

SECTION V. RESIDENCY PROGRAM CURRICULUM Rotations....................................................................................................................………….. 19

WAMC Institutional Education Guidelines……………………………………..……….. 20

Customized training plans

Institutional Conference ……………………………………………………………………….. 21

Departmental Conference

Project Requirements

SECTION VI. EVALUATIONS AND OUTCOMES ASSESSMENTS Evaluations…………………………………………………………………………………………... 23

Entering interest form

Objective-based interest form

Summative evaluation

Learning experience evaluation

Preceptor evaluation

Goal/objective-based residency evaluation

Custom Evaluation

Evaluation Scales ………………………………………………………………………………… 25

Dispute Proceedings ……………………………………………………………………………. 26

SECTION VII. PROGRAM PROCEDURES

ASHP Matching Program..…………………………………………………………………….... 26

Military Selection Procedure…………………………………………………………………. 27

Holidays ………………………………………………………………………………………………. 28

Leave …………………………………………………………………………………………………... 29

Reasons for extension………………………………………………….................................... 30

Emergency Plan …………………………………………………………………………………. 31

Disciplinary Process …………………………………………………………………………… 33

Licensure ……………………………………………………………………………………………. 50

Employee Handbook for Continuous Readiness



SECTION I. INTRODUCTION

Welcome to Fort Bragg, North Carolina! Fort Bragg is one of the busiest military

complexes worldwide, Fort Bragg is home to the legendary 82nd Airborne Division, the

XVIII Airborne Corps, the U.S. Army Special Operations Command, the U.S. Army Forces

Command, the U.S. Army Reserve Command and the U.S. Army Parachute Team, the Golden

Knights. By population, Fort Bragg is the largest Army installation in the world, home to

nearly 10 percent of the Army's active component forces.

Womack Army Medical Center, a state-of-the-art medical complex, is an integral

component of Fort Bragg's military mission. Womack Army Medical Center is dedicated to

Medal of Honor recipient PFC Bryant Homer Womack, a courageous medic who gave his life

tending to the wounds of his fellow soldiers, even though he, himself, had sustained mortal

wounds during a surprise enemy attack in Korea in 1952.

MOTTO “Committed to those we serve”

WAMC Mission, Vision and Values

Mission

Provide the highest quality health care, maximize the medical deploy ability of the force,

ensure the readiness of Womack personnel, and sustain exceptional education and training

programs.

Vision

One Team - Quality Care - Quality Caring.

Values

Loyalty, Duty, Respect, Selfless Service, Honor, Integrity, and Personal Courage

Department of Pharmacy Mission and Vision

Mission

To provide accessible, high quality pharmaceutical care and services, education and

training, and leadership in support of Womack Army Medical Center.

Vision

One Team, Quality Pharmaceutical Care, Quality Caring by: Delivery of quality

pharmaceutical care; Commitment to customer service; Design and management of a fail-

safe medication-use system and Provision of evidence-based drug therapy education and

training.



PGY1 Residency Program Purpose statement

PGY1 pharmacy residency programs build on Doctor of Pharmacy (Pharm.D.) education

and outcomes to contribute to the development of clinical pharmacists responsible for

medication-related care of patients with a wide range of conditions, eligible for board

certification, and eligible for postgraduate year(PGY2) pharmacy residency training.

In keeping with the American Society of Health-System Pharmacists (ASHP) standard, the

Womack Army Medical Center Pharmacy Post-Graduate Year One (PGY1) residency will

provide the opportunity for the resident to:

Develop professionally beyond entry-level professional competence in patient-

centered care and in pharmacy operational services, further developing leadership

skills that can be applied in any position and in any practice setting.

Acquire substantial knowledge required for problem-solving while refining the

resident’s current problem-solving strategies.

Strengthen professional values and attitude, and advance the growth of the

resident’s clinical judgment skills.

Residency Training Outcomes

Graduates of the Womack Army Medical Center Pharmacy PGY1 Residency program will

attain and demonstrate the following ASHP-requisite skills and qualities:

R1: Patient Care (12 objectives) 100% required

R2: Advancing Practice and Improving Patient Care (9 objectives) 88% required

R3: Leadership and Management (6 objectives) 100% required

R4: Teaching, Education, and Dissemination of Knowledge (6 objectives) 66 % required

Potential Residency Electives Outcomes

E1: Pharmacy Research

E2: Added leadership and Practice Management Skills

E3: Home Care Pharmacy

E4: Managed Care Pharmacy

E5: Management of Medical Emergencies

E6: Teaching and Learning

E7: Specialty Pharmacy

E8: Health, Wellness and Emergency Preparedness

Residents Guide to

the RLS.pdf



Departmental Organization Chart

DEPARTMENTAL ORGANIZATIONAL CHART.pdf

SECTION II. REQUIREMENTS

Resident Selection/Contract/Training Agreement

The Long Term Health Education and Training (LTHET) selection board convenes every

year around May to select a(n) active duty resident(s). Individuals selected to receive

training as a PGY-1 Pharmacy Resident at Womack Army Medical Center (WAMC) receive

one-year appointments as residents assigned to the Department of Pharmacy.

Please refer to the Program Procedure section for more information.

Liability Insurance

Military residents are covered by the Department of Defense/Department of the

Army for liability for work within the medical treatment facility, but are encouraged to

obtain some form of additional personal liability insurance for any outside rotation that is

not DoD-affiliated. The resident is expected to achieve all objectives for goal R1 (Patient

Care) prior to the start of any off-site rotation.

Minimum Completion Requirements for the Awarding of a Residency Certificate

In order to receive a residency certificate, the resident must meet the following criteria:

1. Resident must progress over the course of the residency to be more efficient,

effective, and able to work independently in providing direct patient care and must

achieve 89% of program-specific goals and objectives by the completion of the

residency program.

a. R1: 100% of the objectives are required.

b. R2: Only R2.2.4 is not required, 88% of the objectives are only required.

c. R3: 100% of the objectives are required.

d. R4: Only 4 objectives are required to include R4.1.1, 66% of the objectives

are only required.

2. Satisfactorily complete a residency project, to include a publishable manuscript, (or

alternate publication assignment if determined appropriate by the Pharmacy

Residency Advisory Committee (RAC)) in addition to any other assigned duties or

projects as specified by the program director in conjunction with the RAC.

3. Satisfactorily complete a residency project presentation at an appropriate forum to

include pharmacy peers. The usual forums for presentation are the WAMC Research

Symposium, Fayetteville-Lumberton Integrated Residency Training (FLIRT) event,

and the Southeastern Residency Conference for Residents (SERC).



4. Resident must be in good standing with the WAMC health system and credentials

committee and be in compliance with Army standards.

Extensions may be granted on a case by case basis as deemed appropriate by the RAC.

Resident Notebook

The resident will maintain an electronic Residency notebook via PharmAcademic

https://www.pharmacademic.com

The resident is responsible for ensuring all documents are downloaded and stored under

appropriate file categories for the Program Director to review at the end of the residency

year.

Resident Curriculum Vitae

Resident Customized Plan

Quarterly Report of the Resident

Completed assignments throughout the year (Drug Information questions,

presentations, journal clubs, in services, etc.)

Residency Project

Trainings/Certifications

Evaluations (SERC and FLIRT)

PharmAcademic

Prior to start the PGY1 Program the resident must submit:

Pre-Interest Statement for Womack Army Medical Center

ASHP Standard Entering From and Goal-Based Residency Evaluation

An interest and preference informational document will be sent to the resident via

PharmAcademic prior to residency start date, thus allowing time to consider and evaluate a

customized plan for the resident prior to starting the residency year.

Benefits

Military residents will be paid military pay commensurate with rank and time in grade and

will accrue leave at the standard rate for an active duty service member (30 days per year).

He/she will receive medical and dental benefits of an active duty service member.

Additionally, he/she will attend authorized conferences and/or training opportunities in

temporary duty (TDY) status in accordance with the Joint Travel Regulations (JTR).

Out-processing

The PGY1 training year continues until the last training day and DOES NOT end on the date

of graduation ceremony. The RPD will allow military residents an appropriate period of

time (typically 3-5 days), to out-process post.

https://www.pharmacademic.com/



SECTION III. DEPARTMENT AND PROGRAM STRUCTURE

Department Chair

COL Jorge Carrillo Chief, Department of Pharmacy [email protected]

Residency Program Director

MAJ Jessica Hull

Chief, Clinical Pharmacy Services

[email protected]

The Residency Program Director (RPD) is responsible for the overall character of the

residency program. Through appropriate leadership and administrative and management

decisions, he/she is responsible for the development, maintenance, and execution of

program content in accordance with ASHP accreditation standards. The RPD may serve a

dual position as a clinical pharmacist, Clinical Coordinator, Chief of Clinical Pharmacy

Services, Assistant Chief of the Pharmacy, or the Chief of the Pharmacy.


Ms. Denise Bogue

[email protected]

The Residency Program Coordinator/Administrator is in close association with the

program director and is responsible for the day to day conduct of the residency program.

Preceptors

Laura Bowers [email protected]

William Criswell [email protected]

Mallory Howard [email protected]

J. Bradly Hughes [email protected]

Sherry Lamberth [email protected]

Annie Madar [email protected]

Autumn Mittleider [email protected]

Joseph O'Shaughnessy [email protected]

Heather Rhodes-Pope [email protected]

Alisa Spinelli [email protected]

Sarah Voytko [email protected]

Jennifer Welsh [email protected]

Michael Williams [email protected]

mailto:[email protected]


















The Department internal phone roster can be found in the V:

Drive/Pharmacy/Clinical/Admin/Schedule/Internal Phone roster

INTERNAL PHONE

ROSTER.pdf

Preceptors are clinical or staff pharmacists employed and practicing in their area of

expertise. All preceptors will be selected by the Residency Program Director and approved

by the RAC and will have demonstrated familiarity with residency training and/or shown

aptitude and desire to become a residency preceptor.

Preceptors in training

Preceptors in training are pharmacists new to precepting who do not meet the

qualifications for residency preceptors. These preceptors must be assigned an advisor or

coach who is a qualified preceptor and have documented preceptor development plan to

meet qualifications for becoming a residency preceptor within 2 years.

Non-pharmacy preceptors

Non-pharmacy preceptors are physicians, physician assistants, certified nurse

practitioners, and other members of the healthcare team involved in pharmacy resident

education. When they are utilized as preceptors, the learning experience must be

schedule after the RPD and RAC agree that residents are ready for independent practice

and a pharmacist preceptor works closely with the non-pharmacist preceptor to select the

educational goals and objectives for the learning experience.

Residency Academic Advisor/Mentor

The residency advisors are key individuals in assuring that the resident meets the overall

objectives of the program. The residency advisors can serve as mentors for the individual

resident and provide assistance to the resident in formulating individual achievable

program goals.

Residency Project Advisors

Residency Project advisors are preceptors or non-pharmacy preceptors who have

volunteered their time to act as mentors and primary advisors on the resident project.

Committees

Pharmacy Residency Advisory Committee (RAC)

The purpose

To establish procedures that will provide general oversight and guidance to the direction



and operation of the program.

Members

Residency Program Director PGY1(Chair)

Chief of Pharmacy


Three PGY1 preceptors

**Open RAC meetings include all active preceptors and the above members**

Responsibilities

To provide direction and oversight to Womack Army Medical Center Pharmacy

practice residency program

To maintain close link between individuals training sites and the residency program

leadership

To review the content of the program on an ongoing basis to ensure that ASHP and

WAMC standards are met

To ensure all primary residency training sites have access to people knowledgeable

about the residency program who can assist in meeting site-specific needs

To provide a forum for discussion of residency program issues arising at individual

sites

To promote innovation in the curriculum and learning strategies used in the

residency program

To monitor the progress of the residents towards completion of the program, and to

advise on corrective and supportive measures if difficulties are identified.

Establish Program Structure

Assign Educational Goals and Objectives to Specific Learning Experiences

Recommends and approves the residency application process, participates in the

interview process, provides applicant recommendations, provides input to changes

in the residency program, provides input to disciplinary actions and proposals for

resident goal attainment when academic failure is occurring.

Professional Allied Health Education Committee (PAHEC)

The Womack Professional Allied Health Education Committee meets every other month

(odd numbered months) in order to discuss issues related to any residency conducted

within the institution. Members of the PAHEC include the Director of Medical Education

(DME), all residency program directors, the PAHEC Coordinator, one Resident

representative and any named alternates. Resident academic progress is discussed for all

institutional residents. Due process for residents who encounter academic, technical,

and/or professional conduct problems are discussed with procedures pertinent to

academic dismissal. Due process is governed by MEDCEN Pamphlet No. 351-1 Graduate



Medical Education: Due Process for participants in Military Graduate Medical Education

(GME) Programs 1 October 2013, which is referenced through AR 351-3, Professional

Education and Training Programs of the Army Medical Department, 15 October 2007.

Graduate Medical Education Organizational Structure

Organizational

structure of graduate

PAHEC Organizational Structure

ORGANIZATIONAL

CHART OF WAMC PA

SECTION IV. RESIDENT RESPONSIBILITES AND SUPERVISION

Defense Medical Human Resources System-internet (DMHRSi)

Military residents must accurately complete their time in the DMHRSi system in a timely

manner, every two weeks. This is located in the WAMC Intranet/WAMC links/DMHRSi.

Academic and Professional Performance Standards

Residents are expected to satisfactorily complete all requirements of the residency

program in general. Only the residents who satisfactorily complete the requirements will

receive their residency certificate as evidence of program completion. Evaluation of

resident’s progress in completing the requirements is performed during each rotation and

quarterly.

If during the course of the training period, the RAC becomes aware of unsatisfactory

performance or unacceptable misconduct on the part of the resident, the Residency

Program Director (RPD) will initiate a counseling session with the resident to discuss the

problem and to determine the DUE PROCESS for Participants in Military Graduate Medical

Education (GME) Programs in accordance with MEDCEN Pamphlet No 351-3, 23 September

2013.

Army Physical Fitness Test (APFT)

Military residents are evaluated prior to the start of the residency program and semi-

annually using the Army Physical Fitness Test (APFT) in accordance with AR 600-9. The

APFT provides a measure of upper and lower body muscular endurance. It is a

performance test that indicates a Soldier’s ability to perform physically and handle his or

her own body weight. Army Physical Fitness Test standards are adjusted for age and

physiological differences between the genders. The APFT is designed to ensure the



maintenance of a base level of physical fitness essential for every Soldier, regardless of

Army MOS/branch or duty assignment. Soldiers that fail to meet standards outlined in FM

7-22 or AR 600-9 will be flagged from all favorable personnel actions per AR 600-8-2,

enrolled in the company Reconditioning Physical Fitness Training Program and counseled

by the company chain of command accordingly.

Military Evaluation Reports

Military residents will have completed DA Form 67–10 series (Officer Evaluation Reports (OER)) and associated DA Form 67–10–1A (Officer Evaluation Report Support Form (OER Support Form)) documented in the Army’s Evaluation Reporting System (ERS) in accordance with AR 623-3.

Supervision

In accordance with MEDCEN Pamphlet No. 351-4, 23 September 2013 entitled Graduate

Medical Education: Supervision of Medical Students, Nurses & Other Allied Health Trainees

in a Graduate Medical Education (GME) Program, the Professional Allied Health Education

Committee (PAHEC) will document and discuss any citations regarding resident

supervision or Residency Review Committee (RAC) reports. The PAHEC will suggest

methods for correction and follow-up for such citations.

PAM 351-4

SUPERVISION OF ME

Duty Hours

Duty hours are defined as all clinical activities related to residency program. As required by

ASHP Accreditation Standards, duty hours must be limited to 80 hours per week, averaged

over a four week-period, inclusive of all in house call activities, staffing, and moonlighting.

Duty hours will depend on your rotation. Rotation schedules are typically Monday-Friday

but some preceptors may work on weekends, so your schedule will adapt accordingly on

the non-staffing weekends in Inpatient Pharmacy.

Duty Hours

Requirements

Institutional Moonlighting Policy

Outside professional activities must not interfere with resident education. Direct and

indirect effects of moonlighting may adversely impact on both the resident and the

program. Trainees who have NOT completed a residency will NOT engage in moonlighting.



Institutional Moonlighting Policy.pdf

Reporting

Resident will report to the clinical pharmacy office (Building 4-2817 Reilly Road, Room

585) located on the 5th floor, south wing, at 0800 on the date assigned to start the

residency. Instructions to report to Fort Bragg will be provided through the military chain

of command. Further instructions regarding daily reporting for rotations will be provided

by the rotation preceptors.

Wear and Appearance of Army Uniform and Insignia

Military residents will always dress in accordance with AR 670-1: Wear and appearance of

Army Uniforms and Insignia and Commander’s Policy 17: Wear and Appearance of Army

Uniforms and Insignia/Personal Appearance Policy for the appropriate rotation or

occasion. Uniforms will be neat and clean and worn in accordance with policies and

regulations. Military residents will always adhere to military courtesy and attire and are

expected to familiarize themselves with these policies.

AR 670_1 Wear and Appearance of Army Uniforms and Insignia.pdf

Wear and Appearance of Army Uniforms and Insignia Personal Appearance Policy.pdf

Institutional Training

Department of Clinical Investigation, Institutional Review Board (IRB)

Collaborative Institutional Training Initiative (CITI) @ www.citiprogram.org

Department and Program Specific Training During orientation the residents will attend several hospital-mandated classes in addition to online classes. The online training is conducted via the US Army Medical Command Healthcare Continuing Education and Training site via SWANK Healthcare and can be accessed from the WAMC intranet home page Institutional Training

Department of Clinical Investigation, Institutional Review Board (IRB)

Collaborative Institutional Training Initiative (CITI) @ www.citiprogram.org

Basic Life Support (BLS)/Advanced Cardiovascular Life Support (ACLS)

Residents are required to maintain current certification in BLS and ACLS. Residents are

required to complete ACLS certification in order to participate in the management of

medical emergencies. A copy of current certification must be provided to the RPD or

Program Coordinator/Administrator in addition to the credentials office.

http://www.citiprogram.org/




Competency Assessment File (CAF)

Per hospital policy, all staff will have a CAF that includes the minimum requirements related to their position. The resident will have a CAF comprised of his/her job description, orientation, and annual training and non-clinical training. The Credentials Office will maintain verification of qualifications and licensure; Credentials/Licensure Verification Memo will be maintained within the CAF.. These folders are located in the Clinical Administrative office upkeep of this file is the responsibility of the resident.

MEDCEN MEMO 1-6

COMPETENCY ASSES

Presentations

The resident is required to achieve proficiency in communication; visually, verbally and in writing. Therefore, each resident will provide presentation(s) as required by the rotational preceptor. Each individual preceptor will determine the audience and the topic. The residency committee will attend as many of the resident’s presentations as possible and provide feedback using the Presentation Evaluation form. In addition, the resident is required to present one Continuing Education (CE) to the pharmacy team during their residency year. Guidelines for this CE presentation will be provided during orientation.

Standards of Conduct for Department of the Army Personnel

Ethics Code

Residents are to uphold the highest ethical standards and abide the Ethics Code and

guidance in AR 600-50. Military residents are also subject to the Uniform Code of Military

Justice (UCMJ) for disciplinary action(s).

Standard of Conduct AR_600-50_01-28-19

Womack Ethic’s code for the Pharmacy Residency program includes:

Expectation

Improve the institutional work environment through learning, teaching, educating

and through professionalism

Be responsible for your actions

Ethical behavior helps create a work environment that allows creativity and free exchange

of ideas in which no cheating or plagiarism is tolerated. The goal of academic-based

program is to prepare residents to become clinical pharmacists who can evaluate ideas

through the process of analysis and synthesis to produce an original work representative of

their own original thoughts. Womack Army Medical center have a zero tolerance policy

for plagiarism.

According to plagiarism.com, plagiarism is an act of fraud that involves stealing someone

else’s work and lying about it afterward.

Merriam-Webster online dictionary the definition of plagiarism includes the following: ¹



To steal and pass off (the ideas or words) as one’s own

To use (another’s production) without crediting the source

To commit literary theft

To present as new as original an idea or product derived from an existing source.

All of the following are considered plagiarism:

Turning in someone else’s work as your own

Copying words or ideas from someone else without giving credit

Failing to put a quotation in quotation marks

Giving incorrect information about the source of a quotation

Changing words but copying the sentence structure of a source without giving credit

Copying so many words or ideas from a source that it makes up the majority of your

work, whether you give credit or not. ¹Merriam-Webster Online. “Plagiarism." Merriam-Webster.com. Web. 30 Sept. 2013. http://www.merriam-

webster.com/dictionary/plagiarism

Values which guide the Army and Army Pharmacy

Code of Ethics for Pharmacists

The American Pharmacists Association (APhA) cites the pharmacist preamble under the

Code of Ethics for pharmacists as follows: Pharmacists are health professionals who assist

individuals in making the best use of medications. This Code, prepared and supported by

pharmacists, is intended to state publicly the principles that form the fundamental basis of

the roles and responsibilities of pharmacists. These principles, based on moral obligations

and virtues, are established to guide pharmacists in relationships with patients, health

professionals, and society.

Our pharmacy residents all serve U.S soldiers, their beneficiaries, and retirees. We

uphold our code of ethics for our profession while we live the values of those we care

for.

Code of Ethics for Pharmacists.pdf

Loyalty; bear true faith and allegiance to the U.S Constitution, the Army, your unit,

and others

Duty; fulfill your obligation

Respect; treat people as they should be treated

Selfless service; Put the welfare of the nation, the Army, and your subordinates

before your own

Honor; live up to the Army Values

Integrity; Do what is right, legally and morally

Personal Courage; Face fear, danger, or adversity (physical or moral)

http://www.merriam-webster.com/dictionary/plagiarism





Disclosure of Information

To avoid conflicts of interest or appearances of impropriety, pharmacists should disclose

consultant or speaker arrangements or substantial personal financial holdings with

companies under consideration for formulary inclusion or related decisions. To inform

audiences fully, speakers and authors should disclose, when pertinent, consultant or

speaker and research funding arrangements with companies.

The following statement must appear on any PowerPoint presentation for platform

presentation, and on any poster displayed outside of Womack Medical Center: Author

disclaimer "The views expressed herein are those of the author(s) and do not reflect the

official policy of the Department of the Army, Department of Defense, or the U.S. Government."

WAMC Policy and Procedure for Vendor Interaction

Federal ethics policies specify that commercial vendors may only provide gifts to staff and

trainees in accordance with the following guidelines:

Non-cash gifts from vendors with a fair market value of $20 or less per source, per

occasion, with a total for calendar year no greater than $50.

No gifts or cash equivalents (e.g. stocks, bonds) can be accepted.

No gifts can be given with intent to influence duty performance.

Frequent gifts from the same source cannot be accepted because of appearance of

impropriety.

Vendors and representatives may not bring product samples into the facility

without the permission of the Chief of Pharmacy.

Vendors are prohibited from bringing food or beverages onto WAMC premises,

except for their personal consumption. Under no circumstances may food or

beverages be brought into WAMC for distribution to staff or patients.

WAMC strongly discourages faculty and trainees from accepting gifts of any dollar

value within the facility. Gifts bearing a product or company name (pens, notepads,

Venclocks, etc.) should not be kept in a manner visible to patients. Staff and trainees

should not take any action which might suggest that WAMC endorses that product

o r company.

Gifts may never be solicited from vendors, and all gifts require ethics review by the

Center Judge Advocate and Commander approval before acceptance.

Staff and trainees may accept awards through bona fide award programs, but only

after ethics committee and supervisory review.

WAMC provides vendors with facility access under strictly enforced guidelines,

specified in WAMC MEDCEN Reg. 725-4.

o All vendors must register with the Provost Marshal’s Office on the day of any

visit.

o Pharmaceutical representatives must report to the Chief of Pharmacy before

going to work areas, clinical offices, treatment rooms, or any areas where



patients are being treated.

o Vendors must be escorted through patient care areas.

o Residents and Faculty must not provide vendors with access to peers or

supervisors, unless first authorized by the Chief, Department of Medical

Education, in consultation with the Office of the Center Judge Advocate.

Similarly, trainees are never authorized to approve purchases of products,

services, supplies or equipment sold by vendors.

Graduate Medical Education trainees should not organize or promote non-

continuing medical education accredited industry driven activities, engage in

detailing activities (including computer based) for which they receive gifts or

payment, or receive payment for participating in lectures or programs like “peer

groups,” “advisory boards,” or dinner lectures.

WAMC-Vendor

Interaction Policy.pdf

Conferences

Residents will be provided the opportunity to participate in at least one extramural

educational opportunity such as a pharmacy association meeting or a regional residency

conference. The specific event will be determined during the residency program based on

schedule, availability, and the Army Conference Policy. Some examples of potential

activities are listed below:

Fayetteville-Lumberton Integrated Residency Training (FLIRT)

SouthEastern Residency Conference (SERC)

Joint Federal Pharmacy Seminar (JFPS)

Fayetteville-Lumberton Integrated Residency Training (FLIRT)

Local area residency program directors joined together at the Cape Fear Valley Medical

Center-Hoke Pavilion, Southern Regional Allied Health Center (SRAHEC). This organization

goal is to provide collaborative training opportunities for pharmacy residents.

Residents will be provided the opportunity to present their research projects before an

audience of their resident peers as well as area preceptors and residency program

directors. The annual residency seminar opportunity is conducted in the month of April,

thus allowing the residents the time and opportunity to practice and if needed, identify

presentation errors prior to SERC

Southeastern Residency Conference (SERC)

The Southeastern Pharmacy Residency Conference (SERC) was the first of what are now

seven regional residency conferences in the nation. This Conference is an opportunity for

pharmacy residents and graduate students to make formal professional presentations of

their own projects or research; exchange information and ideas with colleagues; discuss



issues confronting institutional practice; and develop intraprofessional relationships.

Institutions representing Alabama, Florida, Georgia, Kentucky, Louisiana, Mississippi,

North Carolina, South Carolina, Tennessee and Puerto Rico are invited to participate.

The SouthEastern Residency Conference (SERC) is held in the spring (April or May) of the

year and is a forum where residents share experiences and expertise. First-year residents

are required present residency projects at SERC. Each resident will make a brief

presentation on their research project, which will be evaluated by preceptors and residents

attending the conference.

Information regarding SERC can be found at www.sercpharm.com.

Joint Federal Pharmacy Seminar (JFPS)

The Joint Federal Pharmacy Seminar (JFPS) is the largest annual event for federal

pharmacy. Uniformed and civil-service pharmacists and pharmacy technicians are invited

to participate in this education and training-filled event. The American Pharmacists

Association, working with the federal pharmacy advisors, coordinates the education and

meeting activities and serves as the Accreditation Council for Pharmacy Education (ACPE)

provider. Attendees will meet to learn and share solutions to challenges facing today's

federal pharmacy professionals. The meeting offers a variety of ACPE-certified continuing

pharmacy education (CPE) and training programs, providing approximately 18 hours of

CPE credit. The education opportunities include industry-supported certificate training

programs as well as presentations and poster sessions focusing on mission-essential

pharmacy operations. The poster abstracts will be published in the Journal of the American

Pharmacists Association (JAPhA). In addition to the educational and training programs,

attendees are provided an opportunity to interact with industry through a very robust

exhibit and training program, with over 100 organizations providing support in the past.

AD2016-14.pdf

SECTION V. RESIDENCY PROGRAM CURRICULUM

Rotations

Core rotations (Mandatory)

Orientation(8 weeks) Ambulatory Care II(4 weeks)

Internal Medicine I(6 weeks) Residency Project(Longitudinal)

Internal Medicine II(4 weeks) Management(Longitudinal)

Leadership/Management(4 weeks) Drug Information(Longitudinal)

Ambulatory Care I (6 weeks) **Service Obligation (Longitudinal)

**Resident will work in Inpatient Pharmacy every other weekend. **

**Elective rotations (4 weeks)

Oncology Anticoagulation

http://www.sercpharm.com/



Pain Management Geriatrics

Leadership Research

ICU PCMH

Medication Safety

** There are only 3 electives allowed during the PGY1 year which 2 out of the 3 are required to be clinical.**

Transitional month (4 weeks)

During the transition month the resident will have time to work on ongoing projects such

as his/her research project or manuscript. The resident is also encouraged to take any

leave during this time to minimize disruption of the structured learning experiences of the

scheduled rotations.

General information

The resident is expected to contact the preceptor at least a week prior to start a new

rotation.

Teaching and modeling opportunities

o Co-precept pharmacy students (P4) on rotation.

o Coordinating pharmacy educational, community, and departmental In-service

o The resident will be given every opportunity to progress through direct

instruction, modeling, coaching and mentoring.

In addition to the core rotations and elective rotations, the pharmacy practice resident is

required to participate in:

o Medication Use Evaluation (MUE)

o Safety Process education and implementation

o Performance Improvement (PI)

o Pharmacy & Therapeutics Committee functions (P&T)

o Formulary Review Committee(FRC)

o Special Order Drugs review (SOD)

o WAMC Symposium

o Lunch & Learn

o Pharmacy Newsletter

Womack Army Medical Center Institutional Educational Guidelines

Department of Medical Education

PAHEC

Department of Medical Education Mission: To provide administrative oversight to 5 related

services in support of professional educational activities at WAMC. The Department of

Medical Education (DME) consists of Graduate Medical Education (GME), Clinical

Investigation Service (CIS), Medical Library, Medical Simulation Center, Continuing Medical



Education (CME) and Professional Allied Health Education Committee (PAHEC)

PAHEC Mission: To deliver quality teaching, excellence in research and distinct experiences

to residents and other healthcare professionals while maintaining the highest standards of

patient care. PAHEC will also provide resources in the form of administrative and financial

support.

This booklet is also posted on the Womack Intranet under SharePoint “Graduate Medical

Education http://team.amed.ds.army.mil/sites/dccs/gme/SitePage/Home.aspx

WAMC 2012-2013

GME Institutional Han

Customized Training Plan

The Customized Plan is required by the accreditation standards developed by ASHP. It

consists of two entries, one entry for the RPD/designee and one entry for the resident. The

Program Director will customize the training program for the resident initially based upon

an assessment of the resident’s Pre-Interest Statement and Goal-Based Evaluation. This

plan is updated quarterly and it is filed in PharmAcademic.

Institutional Conference

WAMC Research Symposium

Submit abstracts via Gmail: [email protected]

Departmental Conference

Resident will present their research project to the Pharmacy Clinical section. Guidelines

will be provided during orientation and project rotation.

Project Requirements

IRB Admin Email address: USARMY Ft Bragg MEDCOM WAMC List WAMC IRB Admin

[email protected]

IRB Committee Members Email address:

usarmy.bragg.medcom-wamc.list.wamc-irb-committee-members@mail.mil

Research versus PI Determination Email address:

usarmy.bragg.medcom-wamc.list.wamc-research-performance-improvement@mail.mil

Proposal to Pharmacy Residency Advisory Committee (RAC)

Each resident is required to complete a major project of publishable quality within the

residency year. The purpose of the project is to teach the resident how objective scientific

reasoning can be used to investigate a question or solve a problem.

The resident will be responsible for designing, executing, completing and presenting a

http://team.amed.ds.army.mil/sites/dccs/gme/SitePage/Home.aspx



mailto:usarmy.bragg.medcom-wamc.list.wamc-irb-committee-members@mail.mil

mailto:usarmy.bragg.medcom-wamc.list.wamc-research-performance-improvement@mail.mil



project/study related to the practice of pharmacy of sufficient merit to be published. The

project/study chosen must be approved by the RAC prior to commencement. The project

advisors will provide frequent feedback to the resident and the RAC on the progress of the

project and its likelihood of completion on schedule.

Template

Resident guide:

Objective: The objective of the project is for the resident to learn to investigate a question

or problem in an objective, scientific manner. The project should provide information that

will contribute to the progress and development of the Pharmacy profession.

Scope of the project: May involve any area of hospital practice but must be completed

within the one year timeframe

Residency project proposal: Concisely written protocol must be submitted and approved

before conducting the major project. The proposal must include a title page; a brief

literature review; a clearly stated hypothesis; the objectives of the project and the project

advisors.

Project proposal should be submitted for review and approval to the RAC and Project

Advisory Committee in stages; draft, rewrite second draft, final approval, etc.

Template format:

Title Page: Title, Resident name, Project advisor name

Introduction: State the purpose of the project. Summarize the rationale for the study or

project. Provide only strictly pertinent references. Make sure the introduction addresses

the following:

Goal: a clear explanation of the question/problem and the purpose of the project

Objectives: a listing of the specific objectives to be met by the project

Need: the rationale of the project and the value of potential results

Methods: Describe you selection of observational or experimental subjects. Identify the

methods and procedures in sufficient detail to allow others to reproduce the results. Give

reference to established methods; give brief description for methods that are not well

known. Identify precisely all drugs used, including generic names, doses, and route of

administration.

Statistics: Describe the statistical methods with enough detail to enable a knowledgeable

reader to verify the appropriateness and indicate how they will be applied.

Ethics: Indicate that the project will be submitted to the Institutional Review Board (IRB), if

human subjects or patients are involved in the study. Actually, submission to the

Department of Clinical Investigations so be sure to follow the protocol template if your

project is determined to proceed through the IRB. To make this determination, submit

your project proposal on the same template for submission to the project advisory

committee to our pharmacy-specific members of the IRB for initial review.



References: Number all references consecutively in the order in which they are first

mentioned in the text. Use appropriate reference format.

Proposal to Institutional Review Board (IRB)

Once approved by the PRAC and Project Advisory Committee, submit your proposal to pharmacy-designated representative on the IRB. Once approved by the IRB to continue, you will be assigned a protocol number and proceed with the research. Manuscript The final manuscript must be approved by the Residency Project Advisory Committee prior

to the certificate of completion of residency being issued.

The resident must complete a presentation to the project advisory committee with results

and have a manuscript of publishable quality accepted by the committee prior to

completion of the program in order to receive his/her certificate.

Extensions may be granted on a case by case basis as deemed appropriate by the RAC.

In order to become familiar with the research process, the resident must complete and pass

(score of >70%) the Collaborative IRB Training Initiative (CITI) Program at

www.citiprogram.org during the orientation period.

When completed provide proof of completion to the RPD or Residency Program Coordinator and saved a copy in the electronic residency notebook. Detailed information on protocol submission and required protocol template and public affairs approval documents can be found on the Department of Clinical Investigations website as well as the V:Phrarmacy: Clinical: Residency: Residency Project

Publication form Any poster presentation, abstract, case report, platform presentation, or displayed outside

of Womack Army Medical Center or submitted for publication to any journal must have all

approvals on this form.

SECTION VI. EVALUATIONS AND OUTCOMES ASSESSMENT

Evaluations

Evaluations must be completed for each rotation by residents and preceptors via

PharmAcademic https://www.pharmacademic.com. A delinquent list of rotation evaluation

reports is published monthly by the Residency Program Coordinator/Administrator and is

presented to the RPD. Copies of all evaluations are maintained on the PharmAcademic

server and are accessible to each resident and preceptor.

Entering Interest

This evaluation helps the program prepare for an entering resident. There are a total of 10

questions for the resident to answer.

Entering Interest

Example.pdf


https://www.pharmacademic.com/



Objective-Based interest form

Residents will assess their level of experience and ability to achieve educational objectives

that will be evaluated throughout the residency year. This interest form will assist the RPP

in preparing the resident year. This form is selected as an entering evaluation for residents

when enrolling.

Objective Based

Interest Form examp

Summative Evaluation

This evaluation consists of objectives marked as Taught and Evaluated assigned to the

resident. Goals which were previously marked as Achieved for the resident, will be

included on this evaluation marked as Achieved with a green “ACHR: YES” button. By

selecting this button, the ACHR history can be view and additional comments can be added.

It is the responsibility of the resident to ask questions and clarify any unclear comments

prior to electronically signing the document. Copies of all evaluations are maintained on

the PharmAcademic server are accessible to the resident and preceptor.

Summative

Evaluation Example.p

Learning Experience Evaluation

The resident will evaluate the learning experience using questions developed by ASHP.

Copies of all evaluations are maintained on the PharmAcademic are accessible to each

resident and preceptor.

Learning Experience Evaluation Example.p

Preceptor Evaluation

The resident will evaluate the preceptor using questions developed by ASHP. Copies of all

evaluations are maintained on the PharmAcademic are accessible to each resident and

preceptor.

Preceptor Evaluation

Example.pdf

Goal/Objective-Based Residency Evaluation

All required elective, and custom educational goals and objectives selected for the resident

will appear on this evaluation. This evaluation will be automatically schedule at the end of the

residency year. Copies of all evaluations are maintained on the PharmAcademic are accessible

to each resident and preceptor.



Goal Based

Residency Evaluation

Custom Evaluation

The RPD can use ASHP evaluations or can create custom evaluations for preceptor

evaluations, learning experiences evaluations, and/or other types of evaluations.

The RPD specifies instructions, questions, and a scale for each question. Copies of all

evaluations are maintained on the PharmAcademic are accessible to each resident.

Preceptor Self-Evaluation

This evaluation is a self-evaluation by the preceptor of his/her performance during the

rotation. This is a type of custom evaluation consisting of 13 questions.

The preceptor and the RPD and/or residency advisor(s) will discuss the resident’s

evaluation of the preceptor in conjunction with the preceptor’s self-evaluation. These

evaluations are working documents of the Department of Pharmacy and are used as

part of the preceptor’s overall evaluation and process. All of the formal evaluations are

discussed with the preceptor and he/she must sign the evaluation to indicate that

he/she was counseled regarding the evaluation. Copies of all evaluations are

maintained on the PharmAcademic server are accessible to each preceptor.

Evaluations Scales

Achieved

Understanding policies and procedures without reminders Initiative with all activities on any rotation (not asking preceptor for daily activities) Independent work Proper literature review and easy retrieval Ease with drug information retrieval

Satisfactory Progress

Needs guidance retrieving drug information Making an effort but still not completely independent with activity Assistance from preceptor with chart review Limited communication skills with providers Disease state knowledge lacking with questions

Needs Improvement

Failure to complete an assignment Unsatisfactory attendance, including being Absent Without Leave (AWOL) Failure to complete an evaluation form as scheduled Failure to improve towards proficiency in the skills necessary to clinical pharmacy practice Repetitive failure to complete assignments Repetitive unsatisfactory attendance, including AWOL Repetitively providing false information on evaluation forms Failure to develop proficiency in the skills necessary to clinical pharmacy practice Providing preceptor with incorrect information Not consulting with preceptor regarding changes with patient



Both resident and preceptor can dispute an evaluation.

Dispute Proceedings The resident has the following rights in a dispute proceeding:

The right to hear the reasons for action as put forth by the preceptor.

The right to review all documents before the meeting.

The right to respond orally and/or in writing to any statements.

The right to request witnesses to speak on his or her behalf or to submit statements

from those witnesses. This request will normally be honored; however, the meeting

will not be unreasonably delayed in order to allow their appearance. The witnesses

may speak on behalf of the resident but may not question the preceptor. The RPD may

limit time allotted for individual comments.

The RPD has the responsibility to ensure the concerns of the preceptor meet

reasonable criteria for the proposed action. The RPD will be encouraged to question

the preceptor to clarify any items to ensure that reasonable criteria are being met.

The RPD will notify the resident in writing within two working days of RAC decision. If the

decision is to extend the residency appointment time in order satisfactory achieve the

residency goals and be granted a residency certificate, the notification will also indicate

that no further appeals through PAHEC may be pursued. Appeals through PAHEC will only

be granted if the resident is placed in any of the PAHEC Due Process description.

The resident will be requested to sign and date the notification to acknowledge receipt. A

copy of this notification and acknowledgment will be maintained in PharmAcademic.

Meeting

If during the meeting an individual begins to disclose information that indicates a violation

of the UCMJ may have occurred, the Residency Program Director will halt the interview,

apprise the individual of his/her rights against self-incrimination and immediately contact

the proper channels. If the individual discloses information the RPD determines may

constitute a violation of the UCMJ, the incident must be referred to the PAHEC for

consideration of further action. Any adverse action that is recommended must afford due

process in accordance with this process.

SECTION VII. PROGRAM PROCEDURES

ASHP Resident Matching Program

Commissioned pharmacy officers are exempted from the participating in the match by

ASHP.

ASHP Resident

Matching Participatio



Military Selection Procedure

Long-term Health Education and Training (LTHET)

LTHET is a full-time, DOD-subsidized (military-sponsored) health or health-related

education or training in a military or civilian facility of 26 weeks or more including

education or training received in preparation for commissioning as a health professions

officer and subsequent commissioning.

AR_3513_Profession al_Education_and_Tr

LTHET Application Flowchart.pdf

Eligibility

A 1-year residency in pharmacy specialties is available to Active Duty (AD) pharmacy

officers and new officer accessions who qualify for a commission as a pharmacist. An AD

officer will not be in competition with a new accession as the ceiling for residency positions

has been increased to accommodate this recruiting tool. New accessions will not be offered

residencies until after AD officers have been selected. AD officers should refer to the

annual message on LTHET to determine eligibility criteria and specialty residencies offered.

Minimum terms of service and Active Duty Service Obligation (ADSO)

The ADSO for the 1-year pharmacy residency program is 3 years or as prescribed by

current DOD guidance.

Officers must reimburse the Government for costs of advanced education for participation

in the fully-funded LTHET program (including LTHET fully-funded residencies and

fellowships) if they voluntarily leave the program (including separation as a conscientious

objector) or because of misconduct or other reasons, fail to complete the ADSO set forth in

this regulation and in their training agreement. The term "fail to complete" means

completing a portion or none of the required period of Service on AD. Costs of advanced

education include tuition, books, supplies, and other education costs incurred by the

Government. They do not include pay, allowances, or travel expenses unless otherwise

specified in this regulation, DODI 6000.13, or law. Interest on reimbursement of advanced

education costs may further be assessed under other existing law or in accordance with

DOD guidance.

Orders and Assignments

Assignment and reassignment orders for AMEDD personnel selected for LTHET are

provided for as follows:

a. PCS orders for LTHET. AMEDD Officer Personnel Branches, AHRC, will issue assignment

instructions assigning officer personnel to student status. Reassignment orders will be

published for:

(1) Successful completion of a course or program.



(2) Failure of a student to meet academic standards established by the institution

concerned.

(3) Removal from the program for medical, disciplinary, or other reasons as determined by

the DHET.

b. Assignments. Students attending civilian institutions will be assigned to the AMEDD

student detachment, AMEDDC& S, Fort Sam Houston, TX 78234–5018, with duty station at

the civilian educational institution being attended.

Extensions

Officers entering training will determine the length of the program before applying.

Requests for extension must be submitted in letter format from the officer concerned

explaining the reason for the required extension. Documentation must also be submitted to

support the extension of when the training will be complete.

Promotion status

Officers in a nonselect status are ineligible to apply. Any officer selected for school, but

nonselect for promotion, will be deleted from the school-select list, except for DC. Officers

attending LTHET who are nonselect for promotion may be continued in LTHET at the

discretion of the chief of the pertinent Corps. DC officers passed over for promotion are

ineligible to apply for or start long-term training programs unless a waiver is granted by

the Chief, DC.

Holidays

Residents are required to work one major and one minor holiday assigned by the RPD, but

may be required to work a holiday if it falls on his/her regular weekend rotation. If the

resident’s regular weekend rotation will fall on a federal holiday, this will be taken into

consideration by the RPD when making the holiday work assignments. Major holidays for

the purpose of this scheduling are considered to be Christmas Day, Thanksgiving Day, and

Independence Day. Military training holidays are not granted during the residency year.

WAMC FY17 Federal Training Holiday and

Leave

Annual Leave

Residents are authorized to take up to 10 duty days of leave during the residency year. It is

recommended that the resident take this leave during the transitional month to reduce

impact on scheduled learning activities and rotations. The resident must submit a DA Form

31 (Request and Authority for Leave) in accordance with Command Policy and Company

procedures. Request for mileage passes must be submitted a minimum of 14 days in

advance, or per Command Policy.



Sick Leave

Military residents must use designated sick call procedures when unable to report for the

residency due to illness. Military residents must the RPD and/or the next military

supervisor in the chain of command, the Residency Coordinator/Administrator, and the

rotation preceptor if he/she must report to sick call or be absent from rotation. Military

officers will be considered absent without leave (AWOL) if the military chain of command is

not contacted. Once the military resident receives any notice of home rest, or quarters, one

copy of the temporary profile, sick slip, or quarters slip must be given to the RPD and/or the

next military supervisor in the chain of command. Military residents may coordinate dental

or routine medical appointments with the preceptor and the RPD (or next military

supervisor in the chain of command). The military resident must always ensure a military

officer in the direct supervisory chain is aware of his/her location and duty status using

appropriate reporting procedures.

Emergency Leave

Residents who must stop training for a leave of absence for a medical issue or family

emergency must obtain approval from the Residency Program Director, Chief of

Pharmacy, and the MEDCOM Directorate of Medical Education per the due process policy

(MEDCON 351-1) prior to purchasing tickets, solidifying plans etc. Communication with

the respective preceptor for the assigned rotation during the period of absence must occur

prior to approval. Residents cannot be gone from any rotation for longer than 50% of the

working days including leave, pass, and TDY without the requirement to repeat that

rotation. Residents with planned absences that may result in program extensions (elective

surgery, planned pregnancy, etc.) should discuss this with their Program Director early in

the academic year. Successful completion of a rotation is based on competence and

proficiency in the rotation and may not be granted if absent, even if excused, if these

qualities have not been demonstrated to the satisfaction of the preceptor and RPD.

Professional and other leaves of Absence

Other leave of absences may be granted on a case by case basis as determined by the RPD.

Absence from training for these purposes is counted against time-in-training requirements

and may result in program extension.

Temporary Duty (TDY) and Permissive Temporary Duty (PTDY)

TDY is fully funded travel and is granted for the purpose of attending meetings, rotations,

short courses, and schools considered a necessary component of the training program.

This will NOT count against the 12 month minimum requirement for the PGY1 as it is

considered active medical training. PTDY is an authorized absence that is not chargeable as

leave, is not considered essential training, and occurs at the trainees own expense and will

count against the 12 month minimum requirement for the residency program.



Pass policy

The Residency Program Director, at his/her discretion, may recommend a resident for a

three (3) day pass. The approval authority for passes is the company commander. It is

discouraged to take leave and passes during the same rotation. Passes may not be taken in

conjunction with TDY. When traveling on non-duty days, mileage passes are required

when traveling outside of a 250 mile radius of WAMC. Mileage passes are not counted

against the 12 month minimum requirement, but 3 day passes when one day would have

been a regularly scheduled duty day will result in the scheduled duty day counting against

the 10 duty days of leave authorized.

Reasons for Extension

For extensions of training, the trainee must be notified in writing and the reasons for the

absence and requires a majority of vote of the RAC and approval by PAHEC. The endorsed

request is then forwarded to the MEDCOM Directorate of Medical Education for approval

and an adjusted graduation date. Army policy may require that individuals who have an

extension of training for non-medical reasons incur an additional military obligation

(AR 351-3 and MEDCEN 351-1).

Military resident extension may be granted on a case by case basis, for medical needs not to

include diagnosed mental instability. If the resident is in academic failure or pending

dismissal; the dismissal will precede any extension that may be granted for medical needs.

Army Regulation

351_1 Professional E PAM_351-1_DUE_PR OCESS_FOR_PARTIC

Area/Hospital Disaster which Impairs Learning Rotation Completion

In the event of a hospital disaster which impairs the working operations of the hospital

itself, depending upon where you are in your rotation learning experiences, collaboration

with the Veterans Administration-Fayetteville may be the training completion option.

Collaborative agreements with the VA-Fayetteville are pending agreement, in the event of

any disaster which impairs operation of WAMC for a significant or extended period of time.

Emergency Plan

Mass Casualty (MASCAL)

Womack Army Medical Center is a designated mass casualty center. The facility must be

able to respond rapidly and effectively to sudden surges caused by either natural disasters

or terrorist attacks.

In the event of a MASCAL, residents are considered essential personnel and are required to

attempt to report to the institution to assist the Department of Pharmacy and the WAMC

mission. The treatment site for the pharmacy department is Support Pharmacy. Residents



are required to sign the WAMC form 25-63 and a copy will be placed in the Competency

Assessment Folder (CAF)

If you cannot report due to road closures, etc. attempt to contact the RPD, Program

Coordinator and the next military supervisor in the chain of command via phone or text to

report your status.

GenPharm SOP Pass Policy Army

5- Pharmacy EMP MARegulation 600_8_10

Inclement Weather

All military personnel are designated as Adverse Weather Emergency Employees (AWE).

Guidelines:

1. AWEs will be required to report to, or remain at, his/her work site during adverse

weather conditions. Employees may be required to work at different work sites

and to work altered work hours during adverse weather operations.

2. AWEs are required to provide written directions to their residence along with a

strip map which includes the street address and telephone number.

3. In the event that the resident cannot report to work due to unsafe conditions,

he/she must contact the RPD, Program Coordinator and the next military

supervisor in the chain of command via email, text, or phone message to relay

his/her status and whereabouts for accountability.

ADVERSE WEATHER EMERGENCY MEMO.p

Area/Hospital Disaster

Policies and Procedures for closure or interruption of Residency/Professional Graduate

Program Training secondary to a disaster

A disaster is any event which occurs that significantly and adversely affects resident or

allied professional graduate trainee experience in the training programs.

The WAMC Commander and the Designated Institution Official (DIO) are

responsible to ensure disaster preparedness with prompt initiation of these

procedures should a catastrophic event occur

Program Directors (PDs) and the DIO will maintain current personnel information

files on all residents and allied graduate trainees and their families to include

contact information in the event of an emergency, in coordination with Troop

Command.

The PDs and DIO will ensure that WAMC trainees participate fully in disaster drills

and exercises to be aware of emergency procedures.



In the event of a disaster, the PDs will establish and maintain accountability of

residents and allied graduate trainees and their families and will report

accountability through appropriate Troop Command channels and the DIO.

The PDs and DIO will ensure that trainees and residents fill appropriate roles in the

institutional response to disaster

When disaster conditions arise that prohibit the Institution from maintaining

applicable ACGME standards and guidelines for PAHEC and any other accredited

graduate programs, the DIO will and the WAMC Commander will notify Northern

Regional Medical Command Commander and the Director for Graduate Medical

Education (DGME) at the Office of The Surgeon General (OTSG) via situational

reports and critical command information reports (CCIRs).

All anticipated program interruptions will be coordinated by the DIO and PDs with

the DGME at OTSG or appropriate Branch or Program Managers to inform the

ACGME or applicable allied educational accrediting agencies of anticipated

disruptions and solutions.

o Long-term closure of programs will follow the procedures defined in the

WAMC Program Closure Policy and DODI 6000.13.

o Army GME policy mandates that if local remedies are not practical, residents

may be transferred to other accredited programs, with first priority being

those in Department of Defense (DoD) training facilities

o If relocation is necessary, it will be achieved via normal DoD and Army

Permanent Change of Station procedures through coordination with MEDCOM

or Enterprise level Program Managers or Directors

o WAMC residents and trainees affected by these conditions will be assigned to

other DoD training programs (Army, Navy, or Air Force) or will be placed in

accredited civilian institutions via Army sponsored civilian training.

o When appropriate, the residents and allied graduate trainees will participate in decisions as to relocation sites.

o All expenses regarding this transfer of residents/ allied graduate trainee

and their families will be handled via existing Army policy, ensuring that

the residents and allied graduate trainees continue to receive regular pay

and allowances and any additional funds that are authorized under Army

policy

o The DIO will provide summaries through WAMC Commander and NRMC

Commander to Director of PAHEC at OTSG or other appropriate Enterprise

Program Manager or Director to maintain ongoing communication with the

Institutional Review Committee Executive Director or other allied

educational accrediting agencies about resident or trainee relocation.

DIO will coordinate with Director of PAHEC at OTSG or other appropriate Enterprise

Program Manager or Director to inform the ACGME or other allied educational



accrediting agencies of plans for future training at WAMC.

If it appears that there will be a long term interruption of training, WAMC may

through MEDCOM or Enterprise level Program Managers or Directors consult with

the ACGME or other allied educational accrediting agencies to request voluntary

withdrawal of accreditation and to apply for accreditation as a new program at a

later date.

Disaster Plan.pdf

Disciplinary Process

Pharmacy Department Level

Residents are expected to conduct themselves in a professional manner and to follow all

pertinent Departmental policies and procedures. Appropriate disciplinary action will be

taken if a resident fails to:

Present him/herself in a professional manner

Make satisfactory progress and achieve 100% individualized goals and objectives

for each rotation, including longitudinal rotations with accompanying evaluations

completed and signed.

Satisfactorily complete a Residency Project, corresponding publishable manuscript

and any other assigned duties as specified by the Pharmacy Residency Activities

Committee (PRAC).

Satisfactorily should complete presentations at the Mini SERC event and

Southeastern Residency Conference for Residents (SERC)

Be in good standing with the WAMC health system and ARMY.

Follow policies and procedures

Immediately upon discovery that the resident is falling behind academically or not

adhering to professional standards, the preceptor will consult with the resident verbally.

Additionally the preceptor will inform the RPD that a verbal discussion has taken place.

If the behavior continues, the preceptor and RPD will direct written counseling and

prepare a plan of action for the resident, with input from the resident in developing a plan.

A discussion can then occur between preceptor, resident and RPD to decide if the resident

needs to repeat the rotation or if objectives have been satisfactory in completion and the

resident can proceed to the next rotation.

Due Process for participants in Professional Allied Health Education Programs

This document outlines the process for management of residents who encounter academic,

technical, and/or professional problems. These procedures describe due process to

include program level remediation, hospital level probation, extension of training, and

termination from training. These procedures present a sequence of corrective actions

emphasizing due process, thorough documentation of all actions, and timeliness of the



process. Due Process must be applied uniformly and fairly to all residents in each program.

Institutional policies apply to all residents in its training programs (Exhibit 1) for issues

relating to professional or academic performance, regardless of the sponsoring service.

Issues of misconduct or noncompliance with service regulations, unrelated to academic or

professional performance, must be managed according to the policies of the resident’s

sponsoring service

Upon entry into a training program, residents are provided a copy of this due process policy

and procedures document. The resident will sign a statement acknowledging receipt and

review of such documents as well as understanding their content. The signed statement

will be maintained in the resident’s training file.

A resident's refusal to acknowledge receipt during any process prescribed herein will not

result in a delay of the action or proceeding.

Documentation

All remedial actions must be based upon thorough written documentation. This begins

with initial counseling followed by written performance evaluations and periodic

statements by the Residency Director and Residency Committee concerning the success of

the resident in achieving designated milestones in professional development.

Assessment of the resident/trainee performance should consider the progressive

development under supervision of the knowledge, skills, and attitudes required for safe,

effective and compassionate patient care commensurate with the resident/trainee level of

advancement and responsibility.

When progress is below expectations, the Program Director must assess:

The adequacy of clinical experience.

The adequacy of supervision.

The adequacy of the resident personal learning program for professional growth

with guidance from the teaching staff.

The resident’s active participation in the educational and scholarly activities of the

program.

Both civilian and military residents will be evaluated at several levels of the residency;

within the first 30 days via TAPES and/or DA 67-9-1 as well as during the 5 week

orientation phase (evaluated via PharmAcademic). Additionally, civilian residents will

receive written counseling updates via TAPES minimally at midpoint but quarterly or more

often if academic or professional issues arise which necessitate more frequent

documentation. Military residents will receive the same counseling via written counseling

updates via the DA 67-9-1 support form at the same ascribed intervals named above for

civilian residents. Any unacceptable academic or professional performance will be reported

to the WRAC initially, and then reported forward to the DME if the unacceptable

performance continues for more than 30 days from the date of the initial report.

Remedial Action



There must be a written plan for any remedial action to include objective criteria by which

improvement can be judged. The remedial action plan is an essential component of each

tier of the evaluation process: verbal/written counseling, program level remediation,

hospital level probation, extension of training and termination. Remedial action plans can

address:

Failure to meet academic or technical performance standards or objectives of

the training program.

Lack of application, to include but not limited to absences, tardiness, and/or

failure to perform clinical duties in a timely or adequate fashion.

Conduct considered unprofessional by the Residency Director and/or

Residency Committee that affects pharmacy practice or the course of training

Failure to meet professional or administrative responsibilities, such as those

prescribing weight, physical fitness, licensure or other requirements

An incident of gross negligence or willful misconduct, including a violation of

the Uniformed Code of Military Justice (UCMJ).

Program Level Remediation (PLR)

This action allows for correction of deficiencies without hospital level probation and

usually follows informal verbal or written counseling and informal remedial action plans.

The DME must be informed of this action in writing by PD prior to initiating this

action

PLR is not considered to be adverse and no formal presentation to the PAHEC is

required.

PLR may not exceed 60 days, and it cannot be extended or repeated. PLR must

precede placement of the resident on hospital level probation except in cases of

gross negligence or willful misconduct as judged by the PD. Residents alleged to

have committed such acts of gross negligence or willful misconduct will be referred

to the PAHEC for immediate summary action.

The PD will identify residents who are academic or professional performance fails

to meet expected standards of knowledge, skills or attitudes.

The Program Director will provide the resident with a clear written remediation

plan including:

o A description of specific deficiencies in performance.

o The methods to use to improve the noted deficiencies.

o A list of objective measures which must be achieved to be removed from

remediation.

o Any restrictions or conditions placed on the resident during remediation

o A time frame for documentation of improvement not to exceed 60 days.

The Program Director will ensure that the resident understands the deficiencies as

well as requirements for improvement and offer counseling and assistance to help



the resident

The Program Director may designate an advisor or mentor to assist the resident

during remediation.

The resident must sign a statement acknowledging program level remediation. The

signed statement will be maintained in the resident’s educational training file.

Hospital Level Probation (HLP)

A PD may propose HLP after a period of PLR or after a single incident of gross

negligence or willful misconduct (Exhibit 2).

HLP is a period of supervision initiated to assist the resident in understanding and

correcting significant specific deficits in knowledge, skills or attitudes.

HLP may be approved, ended or extended only by recommendation of the DME.

Hospital Level Probation may end in return to full training status with or without

extension of training.

The proposal for hospital level probation may be based upon one or more of the

following:

o Documented failure to meet academic or technical performance standards of

the program.

o Lack of progress in the training program.

o Lack of application of the resident’s knowledge or skill.

o Unprofessional conduct (medical and/or military).

o Documented failure to correct deficiencies despite counseling and PLR.

o Documented regression or failure to progress after removal from HLP.

o Disciplinary problems.

o Substance abuse (in accordance with applicable service regulations).

o Failure to obtain or maintain a valid unrestricted state license in compliance

with AGME regulation.

o Failure to comply with weight or physical fitness requirements.

o An incident of gross negligence or willful misconduct, including a violation of

the UCMJ.

o Other circumstances deemed significant by the PD.

Prior to being placed on HLP, the PD must notify the resident in writing that a

proposal for hospital level probation is being considered. The notification must

include specific reasons for the proposed action and provide the resident 5 working

days to submit a written response and meet with the PD

The PD must notify the resident in writing if the proposal for HLP will go forward to

the PAHEC within 2 working days following receipt of the resident's response, if

submitted. The notification must include specific reasons for the contemplated action

and advise the resident of his or her rights for due process under this policy.

o The PD will provide the resident with a copy of the HLP request, as it will be

submitted to the DME (Exhibit 3) and applicable institutional policy on due



process.

o A record of the notification including a signed acknowledgment of receipt of a

copy of the hospital level probation request must be maintained in the

resident’s educational training file.

The PD must submit the request for HLP to the DME immediately after notifying the

resident of the intent to proceed with HLP recommendation. The request should

include the following:

o Specific reasons for the proposed hospital level probation.

o Remediation plan which identifies the steps for improvement during hospital

level probation.

o Measurable endpoints for successful completion of the HLP.

o Recommended duration of HLP.

o The copy of the signed notification to the resident proposing HLP.

o The resident’s response (if any) to the probation proposal.

o Academic file.

o Documentation of all previous counseling. o Results of PLR (if applicable).

Upon receipt of the PD's request for HLP, the DME must determine the date for the

HLP hearing (during the next PAHEC or during special scheduled hearing) and inform

the PD of the date and time within 2 working days. A hearing to address a HLP request

must no sooner than 10 working days after the resident is notified of the decision to

refer the matter for a hearing. The regularly scheduled meeting of the PAHEC may

serve as the HLP hearing, or a special meeting of the PAHEC may be convened to

address the HLP request.

Upon receipt of the DME's decision, the Program Director will notify the resident of

the decision within 2 working days. If the decision is to refer the matter for hearing,

the Program Director will also inform the resident of the date and time of the

hearing and the resident's rights regarding the hearing. A copy of the hospital level

probation request will be made available to all voting members of the PAHEC prior

to and during the hospital level probation hearing.

The resident is encouraged to request a meeting with the DME prior to the HLP

hearing in order to clarify any issues concerning the hearing. The resident will be

given the opportunity to appear before the PAHEC. The resident must provide the

name of any accompanying attorney and witnesses and any supporting

documentation for the hearing to the DME at least 2 working days before the date of

the hearing.

The PAHEC will consider the request and all relevant information presented at the

hearing and renders its recommendation as the initial approval authority for

placement of residents on HLP.

o The decision on the recommendation for HLP will be determined by a vote.

o For the action to go forward there must be a quorum of 50% of the voting



members and greater than 50% must vote in favor of HLP.

o The deliberations and voting will be in closed session. All but the voting

committee members, DME and recorder must leave the room.

o The proceedings and recommendations must be mentioned in the minutes of

the PAHEC, but detailed records of the proceedings and vote will be kept

confidential in the local graduate medical education office.

The DME will prepare a summary of the proceedings and recommendations. This

summary along with the PD’s original request and the resident’s written statements

will be forwarded to the DCCS within 1 working day following the HLP hearing

(Exhibit 4).

The DCCS must notify the DME of his or her concurrence or non-concurrence with

HLP within 2 working days following receipt of the summary of the proceedings and

recommendation.

The DME will notify the resident in writing within 2 working days of the decision

(Exhibit 5). If the decision is to place the resident on HLP, the notification will also

include the resident's right to appeal the decision to the WAMC Commander, within

5 working days of receipt of the HLP the notification by the resident. The resident

must sign and date the notification to acknowledge receipt. A copy of this

notification and acknowledgement will be maintained in the resident training file

The resident may make a one-time submission of an appeal of the probation

decision through the DCCS to the WAMC Commander. The probation request and

PAHEC minutes must accompany the appeal requests for the Commander’s review.

Written notification of the Commander’s decision regarding the appeal must be

provided to the resident within 2 working days following receipt of the appeal. The

decision is final and there is no right to appeal to the Directorate of Medical

Education, MEDCOM, Medical Corps Chief or The Surgeon General.

The period of HLP will generally be at least 30 days and will not exceed 90 days.

o The PAHEC may vote to extend the duration of HLP for up to 90 additional

days on recommendation of the PD.

o Residents who fail to demonstrate adequate improvement after two

consecutive periods of HLP will generally be recommended for termination

under due process procedures by the PD.

The PD will counsel the resident on the terms and conditions of the HLP. This

session must be documented in writing and an acknowledgment signed by the

resident. The PD will assign a faculty advisor to assist the resident with the

remediation plan.

If appropriate, voluntary medical, psychological, or learning disability evaluation

will be offered to the resident, at no cost to the resident during the remediation or

HLP. Requests for evaluation outside the institution will be reviewed on a case-by-

case basis. The resident will be responsible for all costs associated with outside

evaluations.



If the PD determines that a medical, psychological, or learning disability evaluation

is required, and the resident does not choose to voluntarily seek evaluation, the

Commander will determine if a command directed evaluation is appropriate and in

accordance with procedures covered under DoD Instruction 6490.4 and DoD

Directive 6490.0.

The PD will submit a monthly written report to the PAHEC regarding the resident’s

performance during HLP

o A copy of this report will be submitted to the DME and to the probated

resident no later than 3 working days prior to the next scheduled meeting of

the PAHEC.

o The resident will be requested to sign the report acknowledging its receipt.

The resident may also submit written statements on his or her behalf to the

PAHEC.

The DME will notify the Directorate of Medical Education (AGME), MEDCOM, and

ATTN: DASG-PSZ-MG, in writing within five (5) working days following the effective

date any military resident is placed on HLP (Exhibit 6). The Director, AGME will

notify the appropriate authority if the military resident is from another service. The

DME must notify the appropriate organization for any civilian resident placed on

HLP in accordance with the training agreements.

Extension of Training

Under ordinary circumstances, brief periods of absence can be accommodated

without extension of training, provided that the sum of ordinary leave, passes,

convalescent leave, travel time, in-processing/out-processing time and the absence

period do not exceed 30 calendar days in an academic year.

If the recommended HLP period exceeds more than one half the elective times

normally allocated within the residency curriculum, a request for extension may be

initiated.

In instances of more prolonged absence, the PD may recommend extension of

training.

Extension of training, even if part of HLP, is not considered an adverse action and

requires no hearing or appeal. Extension of training may also be recommended for

medical, personal or administrative reasons.

Where an extension of training is requested, the resident must be notified in

writing of the intent to extend training and the reasons for the action. The resident

must sign the notification acknowledging receipt.

A written request for extension with the stated reasons enumerated must be sent to

the PAHEC (Exhibit 9). The PAHEC may recommend extension of training.

o This action requires a majority vote (greater than 50 % of the voting

members present) by the members of the committee and is subject to



approval by the Commander.

o The resident must be notified in writing of the decision for extension of

training and a copy of the acknowledged receipt must be maintained by the

PD in the resident training file.

Since extension of training may affect future assignments, special pays, and

obligations for Army residents, the Directorate of Medical Education (AGME),

MEDCOM, ATTN: DASG-PSZ-MG, must be notified within 5 calendar days of the

action for final approval (Exhibit 10).

Termination from Training

Termination is the most serious action that can be proposed by a Program Director

(Exhibit 11). A recommendation for termination must be based upon one of the

following:

o Failure to satisfactorily progress toward correction of deficiencies while on

hospital level probation.

o Regression or failure to satisfactorily progress after removal from hospital

level probation.

o Any act of gross negligence or willful misconduct. This can include a pattern

of past performance or a single act. Under these circumstances, the resident

may be placed on administrative duties and removed from patient care

responsibilities until resolution of the termination process. Termination

under these circumstances requires notification of the appropriate

credentialing authority.

o Two-time non-select for promotion.

The PD must notify the resident in writing that termination is being considered. The

notification must include specific reasons for the proposed action and provide the

resident 5 working days to submit a written response and meet with the Program

Director. (5 days)

The PD must notify the resident in writing if the proposal for termination will go

forward within 2 working days following receipt of the resident's response, if

submitted. (2 days)

o The notification must include specific reasons for the contemplated action and

advise the resident of his or her rights for due process under this policy.

o The PD will provide the resident with a copy of the termination request that

will be submitted to the DME and applicable institutional policy on due process

(Exhibit 12). A record of the notification including a signed acknowledgment of

receipt of a copy of the termination request must be maintained in the

resident’s training file.

The PD will submit the request for termination to the DME immediately after notifying

the resident of the intent to proceed with a termination request. This request should

include the following:



o Specific reasons for the proposed termination.

o A copy of the probation request.

o The notification to the resident proposing termination. o The resident’s response (if any) to the termination proposal.

o Academic file.

o Documentation of all previous counseling.

o Results of prior remediation or probation periods.

Upon receipt of the PD's request for termination, the DME will determine whether

to convene a termination hearing and inform the PD of the date and time within 2

working days. (2 days)

o A hearing to address a termination request must be held within 10 working

days after the resident is notified of the decision to proceed. The regularly

scheduled meeting of the PAHEC may serve as a termination hearing or a

special meeting of the PAHEC may be convened to address the termination

request. (10 days)

Upon receipt of the DME's decision, the PD will notify the resident of the decision

within 2 working days. If the decision is to refer the matter for a hearing, the PD will

also inform the resident of the date and time of the hearing and the resident's rights

regarding the hearing. A copy of the termination request will be provided to voting

members of the PAHEC prior to the termination hearing. (2 days)

The resident is encouraged to request a meeting with the DME prior to the

termination hearing in order to clarify any issues concerning the hearing.

o The resident will be given the opportunity to appear before the PAHEC.

o If the resident engages legal counsel, the resident must provide the name of

any accompanying attorney and witnesses and any supporting

documentation for the hearing to the DME at least 2 working days before the

date of the hearing.

The PAHEC will consider all relevant information received at the hearing and render

its recommendation as the initial approval authority for termination from training.

o The decision on the recommendation for termination will be by a vote.

o For the action to go forward there must be a 75% quorum of the voting

members and greater than 2/3 present must vote in favor of termination.

o The deliberations and voting will be in closed session. All but the voting

committee members, DME and recorder must leave the room.

o The proceedings and recommendations must be mentioned in the minutes of

the PAHEC, but detailed records of the proceedings and vote will be kept

confidential in the DME office.

The DME will prepare a summary of the proceedings and recommendation. This

summary along with the PD’s original request and the resident’s written statements

will be forwarded to the DCCS within 1 working day following the hearing (Exhibit



13). (1 day)

The DCCS must notify the DME of the decision within 2 working days following

receipt of the summary of proceedings and recommendation. (2 days)

The DME will notify the resident in writing within 2 working days of the decision. If

the decision is to terminate the resident from training (Exhibit 14), the notification

will also include the resident's right to appeal the decision within 5 working days

following the receipt of the notification by the resident. (2 days)

o The resident must sign and date the notification to acknowledge receipt.

o A copy of this notification and acknowledgement will be maintained in the

resident training file.

o The resident may make a one-time submission of an appeal of the

termination decision through the DCCS to the WAMC Commander. The

termination request and PAHEC HLP hearing minutes must be submitted to the Commander for review. Written notification of the

decision regarding an appeal must be provided to the resident within 2 working days following receipt of the appeal. The decision is final

and there is no right to appeal to the Directorate of Medical Education,

MEDCOM, Medical Corps Chief or The Surgeon General. (2 days)

The DME will notify the Directorate of Graduate Medical Education, MEDCOM,

ATTN: DASG-PSZ-MG, in writing within 5 calendar days following the decision to

terminate any military resident (Exhibit 15). This DGME will notify the appropriate

authority if the military resident is from another Service. The DME must notify the

appropriate organization for any civilian resident terminated in accordance with

their training agreements. (5 days)

The due process timeline may take up to 27-30 duty days, as defined in this policy.

Suspension

Residents alleged to have committed acts of gross negligence or willful misconduct will be

referred immediately o the appropriate authorities for summary action and may be

suspended pending investigation and resolution of all allegations. The length of suspension

will be determined by the time required to investigate/adjudicated the trainee’s conduct.

The Residency Director will determine the clinical and administrative activities that the

resident may not participate in, provide the resident with a written notification of the

suspension and accompanying restrictions, and inform the Director of Medical Education

immediately of the action(s) taken. The period of suspension will end when the Resident

Director decides to either reinstate the trainee (without restriction) or refer the situation

to the Pharmacy Practice Residency Committee for further action or recommendations.

Remediation

This program level action allows for correction of deficiencies without probation. The

Residency Director will provide written notification to the Director of Medical Education



prior to initiating this action and coordinate the terms and conditions of the remediation

with the Residency Committee. A remediation period may not exceed six weeks nor be

extended or repeated without prior discussion with the Director of Medical Education. In

general, program level remediation precedes formal academic probation except in cases of

gross negligence or willful misconduct as judged by the Residency Director.

The first time that a resident fails a required core rotation the resident will be placed on

remediation and repeat the required rotation in lieu of participating in an elective rotation.

Should the resident fail another required core rotation, or fail the repeated rotation a

second time, the Residency Director will recommend probation and the resident will repeat

the required core rotation in lieu of the second elective rotation on her/his academic

schedule. A third failure of a required rotation will normally result in dismissal because the

resident will not have the opportunity to repeat and satisfactorily complete the rotation

within the academic year and still fulfill all other academic requirements for the program.

If the resident has two unsatisfactory evaluations for a longitudinal rotation, the Residency

Director and Residency Committee will determine the best course of remediation, usually

remediation during part or all of an elective rotation. The resident will be given notice in

writing of his/her failure to meet the goals and objectives of the rotation and the time

frame for remediation. If there is a discrepancy between the resident’s view of his/her

evaluation and the preceptor’s evaluation, the resident has three working days to meet

with the Residency Director and/or Residency Coordinator to discuss a possible resolution.

The Residency Coordinator, together with the Residency Director, Residency Committee

and the Preceptor, will determine the course of action to be taken.

The Residency Committee will provide the resident with a clear written remediation plan

to include the following:

Description of specific deficiencies in required competencies and previous efforts

(counseling) to fix them.

Methods and resources to be used to improve the noted deficiencies.

List of objectives goals and measures, which must be achieve to successfully complete

remediation.

Restrictions or conditions placed on the resident during the remediation period.

Time frame for documentation of improvement, usually not to exceed six week.

Consequences of not fixing the deficiencies in the allotted time.

The residency Director and Residency Coordinator will ensure that the resident

understands the deficiencies, the requirements for improvement and is offered counseling

and assistance to help the resident rectify the stated deficiencies. The resident will be

offered the opportunity to sign a statement acknowledging program level remediation. The

signed statement will be maintained in the resident’s training file. The Residency Director

may designate an advisor to assist the resident during remediation. Preceptors will

continue to provide weekly written performance evaluations to residents.



Probation

The Residency Director may propose probation after a period of remediation or after a

single incident of gross negligence or willful misconduct. Probation is a period of

supervision initiated to assist the resident in understanding and correcting significant

specific deficits in knowledge, skills or attitudes and behaviors. Probation

recommendations will be approved by the Residency Committee and may not exceed a

period of six weeks. The Residency Committee must also approve the removal of a resident

from probation. There must be a quorum consisting of 50% or more of the members.

Approvals will be determined by a simple majority vote of the members present. Probation

may end in return to full training status, withdrawal or dismissal.

The proposal for probation may be based upon one or more of the following:

Documented failure to meet academic or technical performance standards of the

program.

Lack of application of the resident’s knowledge or skills.

Unprofessional conduct.

Documented failure to correct deficiencies despite remediation.

Documented regression or failure to progress despite remediation.

Disciplinary problems.

Substance abuse.

Failure to obtain or maintain a valid unrestricted pharmacist license.

An incident of gross negligence or willful misconduct.

Other circumstances deemed significant by the Residency Director.

In order for a resident to be placed on probation, the Residency Director must notify the

resident in writing that a proposal for probation is being considered. The notification must

include specific reasons for the proposed action and a copy of the of the Pharmacy Practice

Residency policy on due process. The resident will be given a minimum of three working

days to submit a written response and meet with the Residency Director and Residency

Coordinator. The resident will indicate whether she/he accepts the proposed probation. A

record of the notification including a request signed acknowledgment of receipt and a copy

of the proposed probation will be maintained in the resident’s training file along with a

record of the resident’s acceptance or disagreement with the proposed probation. Copies

of these records will also be given to the Director of Medical Education.

A hearing to address a probation request must be at least three working days after the

resident is notified of the decision to refer the matter for a hearing. The resident may

request to address the Residency Committee id she/he disagrees with the Residency

Director’s recommendation for probation. The Residency Committee will meet with the

resident to discuss the proposal and to advise the resident of his/her right to due process

under this policy. At this meeting, the resident may provide verbal and/or written

feedback. The decision on the recommendation for probation will be determined by vote.



For the action to be approved, greater that 50% of the Residency Committee members

present must vote in favor or probation. The resident will leave the room during the

deliberations and voting. A written summary of the probation hearing will be provided to

the Director of Medical Education.

The Residency Director will notify the resident in writing within two working days of the

Residency Committee’s decision. If the decision is to place the resident on probation, the

notification will also include the resident’s right to appeal the decision to the Director of

Medical Education within three working days following the date the resident receives the

notification. The resident will be requested to sign and date the notification to

acknowledge receipt. A copy of this notification and acknowledgement will be maintained

in the resident’s training file. If the Residency Committee votes to deny the

recommendation, the program director will notify the resident of the committee’s

decision verbally and will provide written notification to the Director of Medical

Education.

The resident may submit a one-time appeal of the probation decision through the Residency

Director to the Director of Medical Education. The Director of Medical Education

will consider the resident’s written appeal, the Residency Director’s probation request, and

documentation of the Residency Committee proceedings and probation decision. Written

notification of the decision regarding an appeal of probation will be provided to the resident

within two working days following receipt of the resident’s appeal. The decision by the

Director of Medical Education is final and may not be appealed any further through

academic channels.

The Residency Director and Residency Coordinator will counsel the resident on the terms

and conditions of the probation. This session must be documented and an

acknowledgment signed by the resident.

If, appropriate, voluntary medical, psychological, or learning disability evaluations may be

offered to the resident, at no cost to the resident during the probation period provided they

are authorized beneficiaries of the military health care system.

Requests for medical evaluation outside the institution will be reviewed on a case-by-case

basis and honored on the basis of the merits of the request. The resident will be

responsible for all cost associated with outside medical evaluations.

The Residency Committee will submit a monthly written report to the Residency Director

regarding the resident’s performance during probation. A copy of this report will be

provided to the Director of Medical Education and to the probated resident no later than

three working days prior to the next scheduled meeting of the Residency Committee. The

resident will be requested to sign the report acknowledging receipt and may submit

written statements to the Residency Committee on his/her behalf.

Completion of Probation

Probation may be ended under several conditions:

The Residency Committee may determine the resident’s performance has improved



and now meets the standard requirements to successfully complete the residency.

The resident will return to full academic standing.

The resident may voluntarily resign from the program. The resident shall submit a

written request to the Residency Director and Residency Coordinator to withdraw

from the training program. The resignation request will acknowledge that by

resigning from training, the resident is making herself or himself available for

immediate reassignment orders to meet the Army’s needs. Civilian trainees will be

released unconditionally.

The resident is dismissed from the program.

Dismissal

Residents may be dismissed only after a period of formal probation or after a single

incident of gross negligence or willful misconduct. A recommendation for dismissal must

be based upon one of the following:

Failure to satisfactorily progress toward correction of deficiencies while on probation.

Regression or failure to satisfactorily progress after removal from probation.

Any act of gross negligence or willful misconduct. This can include a pattern of past

performance or a single act. Under these circumstances, the resident may be placed

on administrative duties and removed from patient care responsibilities until

resolution of the dismissal process. Dismissal under these circumstances may require

notification of the appropriate credentialing authority.

In order for a resident to be dismissed from training, the Residency Director and/or

Residency Coordinator must notify the resident in writing. The notification must include

specific reasons for the proposed action and a copy of the Pharmacy Practice Residency

policy on Due Process. The resident will be given a minimum of three working days to

submit a written response and meet with the Residency Director and Residency

Coordinator. A record of the notification including a signed acknowledgement of receipt of

a copy of the dismissal request and the resident’s response must be maintained in the

resident’s training file. Copies will also be provided to the Director of Medical Education

(DME)

A hearing to address a dismissal request must be a least five working days after the

resident is notified of the decision to refer the matter for a hearing. Recommendations for

dismissal will be approved by the Residency Committee. The resident may ask to address

the Residency Committee if she/he disagrees with the Residency Director’s

recommendation for dismissal. The Residency Committee will meet with the resident to

discuss the proposal and to advise the resident of his/her right to due process under this

policy. At this meeting, the resident may provide verbal and/or written feedback. The

decision on the recommendation for dismissal will be determined by vote. There must be a

quorum consisting of 75% or more of the committee members present. Approvals to

dismiss a resident require at least a two-thirds vote of the members present. The resident

will leave the room during the deliberations and voting. A written summary of the



dismissal hearing will be provided to the Director of Medical Education.

The Residency Director will notify the resident in writing two working days of the

Residency Committee’s decision. If the decision is to dismiss the resident, the notification

will also include the resident’s right to appeal the decision to the Director of Medical

Education within three working days following the date the resident receives the

notification. The resident will be requested to sign and date the notification to acknowledge

receipt. A copy of this notification and acknowledgment will be maintained in the

resident’s training file. If the Residency Committee votes to deny the recommendation, the

program director will notify the resident of the committee’s decision verbally and will

provide written notification to the Director of Medical Education.

Resident’s rights under Due Process and Conduct of PAHEC Hearings on Hospital Level

Probation (HLP) or Termination

The proceedings of the PAHEC are administrative and are not bound by formal rules

of evidence or strict procedural format. Records of the proceedings will be kept by

the PAHEC and the Residency Program for at least five years.

Fifty-percent of the voting membership must be present for hearings on HLP and 75

% present for hearings on termination. At least 1 resident representative must be

present in either situation.

If the resident asks to be present at the hearing but cannot attend the hearing as

scheduled, a reasonable attempt should be made to reschedule the meeting without

causing undue delay in the proceedings.

o Only under exceptional circumstances with the Commander’s approval

should the PAHEC proceed with the hearing without the resident, after

formally documenting the circumstances and the necessity of proceeding in a

timely manner.

The resident has the following rights in the proceedings:

o The right to waive the hearing.

o The right to hear the reasons for action as put forth by the PD.

o The right to review all documents before the committee.

o The right to secure a military legal assistance attorney or a civilian attorney

at the resident’s expense. The attorney may not ask questions or present

arguments, but the resident may consult the attorney during the hearing.

o The right to respond orally and/or in writing to the statements of the PD.

o The right to request witnesses to speak on his or her behalf or to submit

statements from those witnesses. This request will normally be honored;

however, the hearing will not be unreasonably delayed in order to allow their

appearance. The witnesses may speak on behalf of the resident but may not

question members of the PAHEC. The Chair may limit time allotted for

individual comments.

o The right to submit statements or written documents on his or her behalf

and in support of his or her position, or other information to show why other



disposition should not occur.

o The right to appeal a decision.

The PAHEC has the responsibility to ensure the concerns of the PD meet reasonable

criteria for the proposed action. The PAHEC members will be encouraged to

question the PD to clarify any items to ensure that reasonable criteria are being met.

The resident and any accompanying attorney may be present during the

presentation by the PD and other witnesses. The resident may then make any

statements to the committee. The resident and the attorney will be excused prior to

the deliberations and vote.

The Director of Medical Education (DME) will notify the resident in writing within two

working days of the board’s decision. If the decision is to uphold the resident’s dismissal

from training, the notification will also indicate that no further appeals through academic

channels may be pursued. The resident will be requested to sign and date the notification to

acknowledge receipt. A copy of this notification and acknowledgment will be maintained in

the resident’s training file and in the Directorate of Health Education Training.

If the dismissal action is not upheld the resident shall be reinstated in the residency

training program and provided with written standards for satisfactory completion and

written criteria for dismissal for the remainder of the academic year.

Resident will be noted in PharmAcademic as dismissed from the Residency program.

Resident Interviews

Any allegation of substandard academic or unprofessional performance immediately

investigated. If during an interview an individual begins to disclose information that

indicates a violation of the UCMJ may have occurred, the Program Director (PD) will halt

the interview, apprise the individual of his/her rights against self-incrimination and

immediately contact the proper legal and law enforcement channels. If the individual

discloses information the PD determines may constitute a violation of the UCMJ, the

incident must be referred to the Director of Medical Education (DME) for consideration of

further action. Any adverse action that is recommended must afford due process in

accordance with this policy.

Administrative or Judicial Action

If administrative or judicial action is initiated against a resident, the Residency Director will

evaluate available information to determine if a restriction, suspension, or dismissal action

is warranted. The Director of Medical Education (DME) must be notified immediately after

administrative or judicial action is initiated and when it is completed.

Resident Resignation

Residents may submit a written request to the PD resigning from the training

program (Exhibit 13). The resignation request will acknowledge that by resigning



from training, the resident is making him/herself available for immediate

reassignment orders to meet the Army’s needs.

The request will be forwarded to the DME with the PD’s Recommendation (Exhibit

17), a description of the circumstances of the resignation, and whether or not

progress has been satisfactory up until the time of resignation.

o The PD will indicate the number of months of training that has been

successfully completed and whether the resident will be recommended for

future PAHEC training.

o The resident must review the statement by the PD and sign to acknowledge

the review.

The DME will review the case and recommend approval or disapproval to the

Commander to make the final determination.

The Residency Director will notify the US Army pharmacy consultant within 5

calendar days that the military pharmacist is available for assignment.

Civilians residents will be released with notification as indicated in their training

or employment agreements.

PAM_351-1_DUE_PROCESS.pdf

Licensure Military pharmacy practice residents must have an active, unrestricted pharmacy license to be eligible for selection for the residency program and must maintain a current, active, unrestricted US pharmacist license issued by any of the 50 states or Puerto Rico. A copy must be provided to the credential office. Employee handbook for Continuous Readiness Based on the information from The Joint Commission (TJC), ARMY and WAMC Policies This handbook is design to assist staff in preparation for the TJC survey as well as to educate staff about the way WAMC conducts quality business. This handbook contains helpful information such as:

Patient rights and organizational ethics ARMY substance abuse program Medication management Infection control Patient safety

It is the responsibility of the resident to refer to this handbook for any questions or to the organization’s management.

Employee_Handbook.pdf


Notes:

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